Anemia among rural children aged 3-6 in central China and its association with dietary behaviors / 中国学校卫生

Objective@#To understand the status of anemia among rural children aged 3-6 in central China and its relationship with dietary behavior, and to provide reference for prevention and intervention of anemia in rural children.@*Methods@#From April to June 2021, stratified cluster sampling was used to select 1 246 preschool children aged 3 to 6 years old in rural areas in central China. Peripheral blood of the ring finger was collected. Dietary behaviors regarding consumption of cereals and potatoes, fruits, vegetables, soy products, milk, animal foods, food diversity, and drinking water were investigated. Logistic regression analysis was used to analyze the association between anemia and dietary behaviors.@*Results@#The detection rate of anemia in rural children aged 3-6 in central China was 13.88%. The anemia detection rate of left behind children (19.00%) was higher than that of non left behind children (11.27%), and the difference was statistically significant ( χ 2=13.93, P <0.01). Logistic regression analysis showed that the proportion of left behind children ( OR=1.28, 95%CI =1.16-1.56) with anemia was higher than that of non left behind children ( P <0.01). Consumption of animal food intake ≥3 times/week ( OR=0.82, 95%CI =0.69-0.91), and ≥2 kinds of vegetables ( OR= 0.86, 95%CI =0.71-0.93) were associated with lower rate of anemia ( P <0.05).@*Conclusion@#The detection rate of anemia in rural children aged 3-6 years in central China is relatively high, especially in left behind children. Dietary literacy of caregivers should be further improved regarding increased intake of animal foods and vegetables to reduce the risk for anemia in preschoolers.

Association between neonatal birth weight and maternal type 2 diabetes mellitus: a bidirectional Mendelian randomization study / 预防医学

Objective@#To examine the association between neonatal birth weight and maternal type 2 diabetes (T2DM), so as to provide insights into the formulation of the early T2DM prevention and improvements of maternal and children health.@*Methods@#Single-nucleotide polymorphisms (SNPs) were collected from two genome-wide association studies (GWAS) that examined the association between neonatal birth weight and maternal T2DM. Inverse variance weighted method was employed for forward Mendelian randomization with 26 birth weight-associated SNPs as instrumental variables and maternal T2DM as the study outcome and for reverse Mendelian randomization with 18 maternal T2DM-associated SNPs as instrumental variables and maternal effects of neonatal birth weight as the study outcome. The heterogeneity was examined using Cochran's Q test, and the pleiotropy was evaluated using MR-Egger regression, while the robustness of the results was evaluated using leave-one-out test.@*Results@#Cochran's Q test detected heterogeneity across two studies (P=0.019, 0.038), and random effect models were employed. Mendelian randomization showed that an increase in neonatal birth weight by per standard error (approximately 488 g) resulted a 29.9% reduction in the risk of maternal T2DM (OR=0.701, 95%CI: 0.547-0.899), and maternal T2DM increased the neonatal birth weight by 0.074 standard errors (OR=1.074, 95%CI: 1.043-1.106). No horizontal pleiotropy was seen for instrumental variables (P=0.241, 0.188). With each SNP excluded in turn, the results of Mendelian randomization study were robust. @*Conclusion @#There are bidirectional associations between neonatal birth weight and risk of maternal T2DM.

The correlation between reflux esophagitis and Helicobacter pylori infection based on natural population / 中华内科杂志

Objective:Reflux esophagitis (RE) may be negatively correlated with Helicobacter pylori ( H. pylori) infection, but the conclusion and relevant mechanism is still controversial. This study proposed to explore the correlation between RE and H. pylori infection based on natural population. Methods:From July 2013 to December 2014, 3 940 residents aged 40-69 years were recruited in Linqu County of Shandong Province and Hua County of Henan Province by the whole sampling method. All the subjects underwent gastroscopy, and gastric mucosa biopsy specimens were collected for pathological diagnosis and Warthin-Starry (WS) staining to identify H. pylori infection. Venous blood samples of some subjects were collected for H. pylori immunoglobulin G ( H. pylori-IgG) detection. Also, demographic and sociological data were collected. Chi-square test and logistic regression were used to analyze the correlation between RE and H. pylori infection. Results:A total of 359 cases of RE were detected. Excluding RE and other upper gastrointestinal organic diseases, 3 382 cases were considered as controls. Chi-square test showed that WS staining positive rate in RE group was significantly lower than that in control group ( P=0.023), but there was no significant difference in the positive rate of H. pylori-IgG between the two groups ( P=0.281). There were significant differences between RE group and control group in gender composition, age, body mass index (BMI), smoking, alcohol consumption, education level and mucosal active inflammation. Multivariate regression analysis showed that RE was negatively correlated with gastric mucosa active inflammation [ OR=0.754 (95% CI 0.600-0.949), P=0.016], and positively correlated with male [ OR=4.231 (95% CI 3.263-5.486), P<0.001], age ≥60 years, BMI≥24 kg/m 2 [ OR=1.540 (95% CI 1.220-1.945), P<0.001]. Compared to those aged 40-49 years and 50-59 years, the odds ratio ( OR) of RE in these aged ≥60 years were 1.566 (95% CI 1.144-2.143, P=0.005) and 1.405 (95% CI 1.093-1.805, P=0.008). Conclusion:RE is more closely related to H. pylori present infection. Multivariate analysis showed that RE is negatively correlated with active inflammation of gastric mucosa caused by H. pylori infection, and positively correlated with male, overweight and aged ≥60 years.

Correlation between lipid metabolism and heart rate deflection point among Tibetan primary school students in Ganzi high altitude area / 中国学校卫生

Objective@#To understand the relationship between lipid metabolism and heart rate deflection point (HRDP) in Tibetan children in the high altitude area of Ganzi, and to provide reference for effective obesity prevention and physical exercise intervention for Tibetan children.@*Methods@#From September to October 2019, 284 Tibetan primary school students living in Ganzi area were randomly selected. HRDP and deflection point speed with different body mass index (BMI) by increasing load method, as well as serum lipid metabolism were assessed. The correlation between the HRDP and lipid metabolism level was analyzed.@*Results@#There were statistically significant differences in serum leptin, adiponectin, total cholesterol, and triglyceride levels among the first and second grade Tibetan primary school students in the Ganzi high altitude area with different nutritional status ( F =22.16, 10.12, 11.24, 4.35, P <0.05). The heart rate values at the HRDP in the first and second grades, the third and fourth grades, and the fifth and sixth grades under different nutritional status were compared, and the differences were statistically significant ( F =3.35, 4.76, 4.68, P <0.05). Pearson correlation analysis showed that there were statistically significant correlations between HRDP and serum leptin in the obese, overweight, normal, and lean groups in the first and second grades of primary school ( r =0.66, 0.14, 0.45, 0.65 , P <0.05).@*Conclusion@#There is a close relationship between HRDP and lipid metabolism of Tibetan children in the high altitude area of Ganzi, and the heart rate at the deflection point can be used as an effective reference intensity for exercise intervention in plateau children.

Epidemiological and clinical features of functional dyspepsia in a region with a high incidence of esophageal cancer in China / 中华医学杂志(英文版)

BACKGROUND@#Functional dyspepsia (FD) has rarely been investigated in areas with a high prevalence of esophageal squamous cell carcinoma (ESCC). This study aims to reveal the epidemiological and clinical features of FD and organic dyspepsia (OD) in such a population.@*METHODS@#A middle-aged and elderly population-based study was conducted in a region with a high incidence of ESCC. All participants completed the Gastroesophageal Reflux Disease Questionnaire and Functional Gastrointestinal Disease Rome III Diagnostic Questionnaire, and they underwent gastroscopy. After exclusion of gastroesophageal reflux disease, uninvestigated dyspepsia (UID) was divided into OD and FD for further analyses.@*RESULTS@#A total of 2916 participants were enrolled from July 2013 to March 2014 in China. We detected 166 UID cases with questionnaires, in which 17 patients with OD and 149 with FD were diagnosed via gastroscopy. OD cases presented as reflux esophagitis (RE), ESCC, and duodenal ulcer. Heartburn (52.94%) and reflux (29.41%) were common in OD, but no symptomatic differences were found between FD and OD. Male sex, low education level, and liquid food were the risk factors for OD, while frequent fresh vegetable consumption was a protective factor. FD included 56 (37.58%) cases of postprandial distress syndrome (PDS), 52 (34.89%) of epigastric pain syndrome (EPS), nine (6.04%) of PDS + EPS, and 32 (21.48%) of FD + functional esophageal disorders. The Helicobacter pylori infection rate in FD patients was not higher than that in the control group (34.23% vs. 42.26%, P = 0.240). Frequent spicy food consumption was associated with PDS (odds ratio [OR]: 2.088, 95% confidence interval [CI]: 1.028-4.243), while consumption of deep well water was protective for PDS (OR: 0.431, 95% CI: 0.251-0.741).@*CONCLUSIONS@#The prevalence of FD was 5.11% in the studied population. Gastroscopy should be prescribed for dyspepsia patients in case that ESCC and RE would be missed in UID cases diagnosed solely by the Rome III questionnaire.@*TRIAL REGISTRATION@#ClinicalTrials.gov, NCT01688908; https://clinicaltrials.gov/ct2/show/record/NCT01688908.

Family history of esophageal cancer modifies the association of serum lipids and malignant esophageal lesions: a nested case-control study from the "Endoscopic Screening for Esophageal Cancer in China" trial / 中华医学杂志(英文版)

BACKGROUND@#The association of lipids and cancer has varied greatly among different cancer types, lipid components and study populations. This study is aimed to investigate the association of serum lipids and the risk of malignant lesions in esophageal squamous epithelium.@*METHODS@#In the "Endoscopic Screening for Esophageal Cancer in China" (ESECC) trial, serum samples were collected and tested for total cholesterol (TC), triglycerides, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol at the time of subject enrollment. Cases were defined as malignant esophageal lesions identified by baseline endoscopic examination or by follow-up to May 31, 2018. Controls were randomly selected using incidence density sampling in the same cohort. Conditional logistic models were applied to identify the association of serum lipids and the risk of malignant esophageal lesions. Effect modification was evaluated by testing interaction terms of the factor under assessment and these serum lipid indicators.@*RESULTS@#No consistent association between serum lipid levels and esophageal malignant lesions were found in a pooled analysis of 211 cases and 2101 controls. For individuals with a family history of esophageal cancer (EC), high TC, and LDL-C were associated with a significantly increased risk of having malignant lesions (odds ratio [OR]High vs. Low TC = 2.22, 95% confidence interval [CI]: 1.14-4.35; ORHigh vs. Low LDL-C = 1.93, 95% CI: 1.01-3.65). However, a negative association was observed in participants without an EC family history (ORHigh vs. Low TC = 0.69, 95% CI: 0.48-0.98, Pinteraction = 0.002; ORHigh vs. Low LDL-C = 0.50, 95% CI: 0.34-0.76, Pinteraction < 0.001).@*CONCLUSIONS@#In this study, we found that the association of serum lipids and malignant esophageal lesions might be modified by EC family history. The stratified analysis would be crucial for population-based studies investigating the association of serum lipids and cancer. The mechanism by which a family history of EC modifies this association warrants further investigation.

A population-based survey of gastroesophageal reflux disease in a region with high prevalence of esophageal cancer in China / 中华医学杂志(英文版)

BACKGROUND@#The exact relationship between gastroesophageal reflux disease (GERD) and esophageal squamous cell cancer (ESCC) is far from clarification. The aim of this study was to investigate the epidemiology of GERD in a region with high prevalence of ESCC in China.@*METHODS@#A population-based, cross-sectional study was conducted in a high ESCC prevalent area, Anyang, Henan, China. All subjects fulfilled questionnaires and underwent gastroendoscopy with routine esophageal biopsy. The subjects were divided into GERD subtypes (reflux esophagitis [RE] and non-erosive reflux disease [NERD]) and controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to examine risk factors for RE and NERD.@*RESULTS@#A total of 2844 subjects were finally enrolled. The prevalence of GERD (RE + NERD) was 17.3%. Among them, 271 (9.53%) adults were diagnosed with RE. The prevalence of RE increased with age (7.09% in 45-50 years, 8.00% in 51-60 years, and 9.53% in 61-69 years, χ = 62.216, P < 0.001). Sixty-seven (2.36%) subjects were diagnosed with the silent RE. A total of 221 (7.77%) subjects were diagnosed with NERD. Frequent liquid food consumption (OR [95% CI]: 1.502 [1.076-2.095]) was independent risk factor for RE as well as age, male gender, high body mass index (BMI), ever smoking. Age was independent risk factor for NERD. For silent RE, age, male gender, and frequent liquid food consumption were risk factors.@*CONCLUSIONS@#In the population with high prevalence of ESCC, a high prevalence of GERD and inverted proportion of RE/NERD were presented. Age was an independent risk factor for GERD. The male gender, high BMI, smoking, and frequent liquid food consumption may be risk factors for RE but not for NERD.

A population-based survey of gastroesophageal reflux disease in a region with high prevalence of esophageal cancer in China / 中华医学杂志(英文版)

Background@#The exact relationship between gastroesophageal reflux disease (GERD) and esophageal squamous cell cancer (ESCC) is far from clarification. The aim of this study was to investigate the epidemiology of GERD in a region with high prevalence of ESCC in China.@*Methods@#A population-based, cross-sectional study was conducted in a high ESCC prevalent area, Anyang, Henan, China. All subjects fulfilled questionnaires and underwent gastroendoscopy with routine esophageal biopsy. The subjects were divided into GERD subtypes (reflux esophagitis [RE] and non-erosive reflux disease [NERD]) and controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to examine risk factors for RE and NERD.@*Results@#A total of 2844 subjects were finally enrolled. The prevalence of GERD (RE + NERD) was 17.3%. Among them, 271 (9.53%) adults were diagnosed with RE. The prevalence of RE increased with age (7.09% in 45–50 years, 8.00% in 51–60 years, and 9.53% in 61–69 years, χ2 = 62.216, P < 0.001). Sixty-seven (2.36%) subjects were diagnosed with the silent RE. A total of 221 (7.77%) subjects were diagnosed with NERD. Frequent liquid food consumption (OR [95% CI]: 1.502 [1.076–2.095]) was independent risk factor for RE as well as age, male gender, high body mass index (BMI), ever smoking. Age was independent risk factor for NERD. For silent RE, age, male gender, and frequent liquid food consumption were risk factors.@*Conclusions@#In the population with high prevalence of ESCC, a high prevalence of GERD and inverted proportion of RE/NERD were presented. Age was an independent risk factor for GERD. The male gender, high BMI, smoking, and frequent liquid food consumption may be risk factors for RE but not for NERD.

Prognostic impact of diabetes mellitus on patients with hepatocellular carcinoma after curative resection / 中华普通外科杂志

Objective To retrospectively assess the prognostic impact of diabetes mellitus (DM) on patients with hepatocellular carcinoma (HCC) after curative resection.Methods A total of 417 HCC patients who had undergone curative hepatic resection were included into two groups.108 patients were classified into DM group and 309 patients into the non-DM group.Overall survival,disease-free survival,postoperative morbidity and mortality were compared between the two groups after reducing confounding bias by propensity score matching.Independent prognostic predictors were determined by Cox proportional hazards model.Results Propensity score matching resulted in 89 patients in each group,and variables were balanced between two groups.In the matched cohort,DM and non-DM groups showed similar morbidity and 30-and 90-day mortality after curative hepatectomy (respectively x2 =0.837,x2 =Fisher,x2 =Fisher,all P ＞ 0.05),the 1-,3-,and 5-year overall survival rates were 82.0％,59.9％,and 33.4％ in DM group and 90.7％,79.1％,and 69.3％ in non-DM group,respectively(P =0.001),however,there was no significant difference in disease-free survival between DM and non-DM groups.Cox multivariate analysis revealed that DM is an independent risk factor for overall survival in patients with HCC after curative resection,but not for disease-free survival.Conclusions DM does not increase the postoperative morbidity or mortality for patients with HCC after curative resection,however,DM may increase the risk of mortality of HCC patients in the long-term.

Thymosin alpha 1 for patients with hepatocellular carcinoma after radical hepatectomy / 中国肿瘤临床

Objective: The effect of thymosin alpha 1 (Tα1) on patients with hepatocellular carcinoma (HCC) after radical hepatectomy was assessed. Methods: A total of 558 HCC patients treated by radical hepatectomy were retrospectively collected. Patients in the treatment group (n=146) received postoperative Tα1 therapy, whereas patients in the control group (n=412) did not. Propensity scale matching was conducted to improve the balance between the two groups. Changes in liver function, recurrence-free survival rates, and overall survival rates were compared between the two groups. Results: Postoperative liver function (i.e., TBIL, ALB, ALT, and PT) in the treatment group was significantly better than that in the control group (P<0.05). The one-, two-, and three-year recurrence-free survival rates and overall survival rates in the treatment group were significantly higher than those in the control group (P=0.019 and P=0.011, respectively). Conclusion:Postoperative Tα1 therapy can improve postoperative liver function, thus significantly prolonging recurrence-free survival and overall survival.

Hepatic resection for hepatocellular carcinoma with or without postoperative adjuvant transarterial chemoembolization: a comparative study / 中华肝胆外科杂志

Objective To explore the efficacy of postoperative adjuvant transarterial chemoembolization (TACE) on the survival of patients after radical resection for hepatocellular carcinoma (HCC).Methods Between March 2007 and March 2010,229 HCC patients who underwent radical resection were retrospectively studied.Patients who underwent resection alone were used as the control group (138 patients) while those who received post-operative adjuvant TACE was used as the interventional group.In order to balance the covariates between the groups,a matched comparison of the patients was done by selecting patients using the propensity score matching (PSM).Then,the efficacy of adjuvant TACE upon survival was evaluated.Results After PSM,we obtained 67 pairs of patients.The survival time for the interventional and the control groups were 32.1 months and 28.3 months respectively.The survival rates at year 1,2,3 post-resection were 94.0％,84.8％ and 75.3％ in the interventional group versus 83.6％,69.9％ and 61.5％ in the control group respectively.There were no significant differences between the two groups (P =0.062).Univariate analysis showed the serum level of AFP,tumor size,number of tumor,BCLC stage,and adjuvant TACE significantly affected the survival of HCC patients who received radical resection (P ＜0.05).Cox model suggested that AFP≥400 μg/L and tumor diameter ＞ 5 cm were independent risk factors of survival for HCC patients who received radical resection (P ＜ 0.05).Conclusion Postoperative adjuvant TACE had no positive effect on survival,and AFP level ≥ 400 μg/L and tumor size ＞5 cm were independent risk factors of survival of HCC patients who received radical resection.

Purification of metallo-B-lactamase CcrA from Bacteroides fragilis with salting-out method

A simple and effective salting-out method was developed for the purification of the metallo-β-lactamase CcrA from Bacteroides fragilis based on the plasmid pMSZ02, in which the crude protein secreted into growth medium was precipitated by 80% sulfate saturation of the medium and purified with Q-Sepharose to offer pure CcrA with yield of 20.1 mg per litter medium. The dependence of the amount of protein precipitation on sulfate saturation was investigated, which showed that more than 80% sulfate saturation resulted the maximum protein precipitated. The purified CcrA was evaluated by steady-state kinetics using penicillin G and cephalothin V as substrates, which showed the Km values of 68±2 and 17±2 µM and Kcat values of 63±1 and 102±3 S-1, respectively. The comparison with the data of the protein from literature method showed that the salting-out method was viable, and it could be useful for the purification of other proteins secreted into growth medium.

Comparison of dosiology between three dimensional conformal and intensity-modulated radiotherapies (5 and 7 fields) in gastric cancer post-surgery / 华中科技大学学报（医学）（英德文版）

The purpose of this study was to compare the dose distribution of intensity-modulated radiotherapy (IMRT) in 7 and 5 fields as well as 3-D conformal radiotherapy (3D-CRT) plans for gastric cancer using dosimetric analysis. In 15 patients with gastric cancer after D1 resection, dosimetric parameters for IMRT (7 and 5 fields) and 3D-CRT were calculated with a total dose of 45 Gy (1.8 Gy/day). These parameters included the conformal index (CI), homogeneity index (HI), maximum dose spot for the planned target volume (PTV), dose-volume histogram (DVH) and dose distribution in the organs at risk (OAR), mean dose (Dmean), maximal dose (Dmax) in the spinal cord, percentage of the normal liver volume receiving more than 30 Gy (V30) and percentage of the normal kidney volume receiving more than 20 Gy (V20). IMRT (7 and 5 fields) and 3D-CRT achieved the PTV coverage. However, IMRT presented significantly higher CI and HI values and lower maximum dose spot distribution than 3D-CRT (P=0.001). For dose distribution of OAR, IMRT had a significantly lower Dmean and Dmax in spinal cord than 3D-CRT (P=0.009). There was no obvious difference in V30 of liver and V20 of kidney between IMRT and 3D-CRT, but 5-field IMRT showed lower Dmean in the normal liver than other two plans (P=0.001). IMRT revealed favorable tumor coverage as compared to 3D-CRT and IMRT plans. Specifically, 5-field IMRT plan was superior to 3D-CRT in protecting the spinal cord and liver, but this superiority was not observed in the kidney. Further studies are needed to compare differences among the three approaches.

Comparison of dosiology between three dimensional conformal and intensity-modulated radiotherapies (5 and 7 fields) in gastric cancer post-surgery / 华中科技大学学报（医学）（英德文版）

The purpose of this study was to compare the dose distribution of intensity-modulated radiotherapy (IMRT) in 7 and 5 fields as well as 3-D conformal radiotherapy (3D-CRT) plans for gastric cancer using dosimetric analysis. In 15 patients with gastric cancer after D1 resection, dosimetric parameters for IMRT (7 and 5 fields) and 3D-CRT were calculated with a total dose of 45 Gy (1.8 Gy/day). These parameters included the conformal index (CI), homogeneity index (HI), maximum dose spot for the planned target volume (PTV), dose-volume histogram (DVH) and dose distribution in the organs at risk (OAR), mean dose (Dmean), maximal dose (Dmax) in the spinal cord, percentage of the normal liver volume receiving more than 30 Gy (V30) and percentage of the normal kidney volume receiving more than 20 Gy (V20). IMRT (7 and 5 fields) and 3D-CRT achieved the PTV coverage. However, IMRT presented significantly higher CI and HI values and lower maximum dose spot distribution than 3D-CRT (P=0.001). For dose distribution of OAR, IMRT had a significantly lower Dmean and Dmax in spinal cord than 3D-CRT (P=0.009). There was no obvious difference in V30 of liver and V20 of kidney between IMRT and 3D-CRT, but 5-field IMRT showed lower Dmean in the normal liver than other two plans (P=0.001). IMRT revealed favorable tumor coverage as compared to 3D-CRT and IMRT plans. Specifically, 5-field IMRT plan was superior to 3D-CRT in protecting the spinal cord and liver, but this superiority was not observed in the kidney. Further studies are needed to compare differences among the three approaches.

Antiviral therapy for hepatitis B virus-related hepatocellular carcinoma after radical hepatectomy / 中国肿瘤临床

Objective:The effect of antiviral therapy for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after radical hepatectomy was assessed. Methods:A total of 478 HBV-HCC patients treated by radical hepatectomy were retrospectively col-lected. Patients in the treatment group (n=141) received postoperative lamivudine therapy (100 mg/d), whereas patients in the control group (n=337) did not. Recurrence-free survival rates, overall survival rates, treatments for recurrent HCC and cause of death were com-pared between the two groups. Propensity score matching was also conducted to reduce confounding bias between the groups. Results:The one-, three-, and five-year recurrence-free survival rates didn't significantly differ between the two groups (P=0.778);however, the one-, three-, and five-year overall survival rates in the treatment group were significantly higher than those in the control group (P=0.002). Similar results were observed in the matched data. Subgroup analysis showed that antiviral treatment conferred a significant sur-vival benefit for Barcelona Clinical Liver Cancer stage A/B patients. Following HCC recurrence, more people in the treatment group were able to choose curative treatments than those in the control group (P=0.031). For cause of death, fewer people in the treatment group died of liver failure than those in the control group (P=0.041). Conclusion:Postoperative antiviral therapy increases chances of receiving curative treatments for recurrent HCC and prevents death because of liver failure, thereby significantly prolonging overall sur-vival, especially in early-or intermedian-stage tumors.

Gene expression profiling study of HPV-16 positive and HPV-negative esophageal squamous cell carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the difference in gene expression between human papillomavirus (HPV)16-positive and HPV-negative esophageal squamous cell carcinoma(ESCC) .</p><p><b>METHODS</b>Eight HPV 16-positive and seven HPV-negative ESCC specimens were evaluated by PCR. The samples were then determined for gene expression profiling using Solexa Sequencing Chip followed by bioinformatics analysis.</p><p><b>RESULTS</b>A total of 796 differentially expressed genes between HPV 16-positive and HPV-negative ESCC were observed. Among them, 366 were up-regulated while 430 were down-regulated. Functional classification and pathway analysis showed that the functions of these genes were mostly related to tumor morphology, immune, and inflammatory response, cellular growth and proliferation and cellular movement. Of these, factors related to immune and inflammation were the most representative.</p><p><b>CONCLUSION</b>Differences in immunologic factors may be associated with HPV infection in esophageal cancer.</p>

Feature and significance of bacterial biofilm formation in middle-ear mucosa in the rat model of acute otitis media / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the relationship between bacterial biofilm and acute otitis media by observing the feature of bacterial biofilm formation in middle-ear mucosa in the rat model of acute otitis media and to study the possibility of application this rat model in bacterial biofilm research.</p><p><b>METHODS</b>A total of 30 healthy, male SD rats were studied, 24 animals served as experimental group were bilaterally injected with 50 µl of Streptococcus pneumoniae suspension (1 × 10(8) CFU/ml) via a transbullar approach into the middle ear cavity after anesthesia and six animals were bilaterally inoculated equivalent saline account for control group. At day 1, 3, 5, 7, 10 and 14 after inoculation, bilateral middle-ear mucosal specimens were collected from three infected animals and one control animal for scanning electron microscopy (SME). Membranoid substance attached the bilateral middle ear mucosa were collected under the microscope from the other one infected animals, which were prepared for confocal laser scanning microscope (CLSM) with immunofluorescence in situ labeling technique and light microscopy using Gram staining.</p><p><b>RESULTS</b>At the early stage of infection (1 day, 3 days), lots of bacterial adhesion, permanent planting in the local regions of the middle ear cavity and microcolonies formation were found, with mixed phagocytic cells, showing a primary bacterial biofilms formation. In the middle term of infection (5 days, 7 days), mature bacterial biofilm scattered on the mucosal surface, formed characteristic three-dimensional structure of "mushroom-shaped" towers. At the late inflammatory period (10 days, 14 days), the bacterial biofilms presented signs of recession. CLSM with FITC-ConA and PI double staining in situ labeling and light microscopy using Gram staining indicated that bacteria and polysaccharide matrix within the biofilms were viable.</p><p><b>CONCLUSIONS</b>These preliminary findings provide evidence that bacterial biofilms form at the early phase of acute middle ear infection and it may be an important factor in the development of recurrent or persistent otitis media. The rat model of AOM established in this study may be an ideal animal model facilitating the bacterial biofilms research.</p>

Intensity-modulated radiotherapy for sinonasal teratocarcinosarcoma / 华中科技大学学报（医学）（英德文版）

Surgical excision and postoperative radiotherapy are widely accepted therapeutic modalities for sinonasal teratocarcinosarcoma (SNTCS). Previous studies have shown that intensity-modulated radiation therapy (IMRT) is safe and effective for the treatment of some sinonasal malignancies. We hypothesize that use of IMRT for SNTCS may result in clinical benefits. We report here two cases of SNTCS that were treated by IMRT. One patient was given extensive IMRT involving elective neck irradiation. Follow-up examinations revealed no recurrence and metastasis 3.5 years after IMRT. Another patient simultaneously suffered from multiple systematical diseases and was administered involved-field radiotherapy. He was found to have a marginal recurrence during the follow up and eventually died 8 months after disease diagnosis. It was suggested in this study that appropriate use of IMRT for the treatment of SNTCS may achieve excellent local control.

Sorafenib for advanced hepatocellular carcinoma: a systematic review / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the effectiveness and toxicity of sorafenib for advanced hepatocellular carcinoma.</p><p><b>METHODS</b>According to the Cochrane handbook for systematic review, two reviewers independently completed the whole process of literature search, study selection, data collection, and quality assessment. Seven electric databases(PubMed, Cochrane Library, Embase, Chinese Journal Full-text Database, Chinese Biomedical Literature Database, Chinese Scientific and Technical Journal Database, Chinese Medical Association Digital Periodicals Database) were searched and randomized controlled trials (RCT) of sorafenib in the treatment of advanced hepatocellular carcinoma were collected and analyzed.</p><p><b>RESULTS</b>Two RCT involving 828 patients were finally included. Compared with placebo, sorafenib significantly extended the overall survival and time to radiologic progression and improved the disease control rate. The main adverse effects were systemic, gastrointestinal, and dermatologic symptoms (grade 1 or 2 in severity), although the incidences were significantly higher in sorafenib groups than in control groups.</p><p><b>CONCLUSION</b>Sorafenib is effective and safe for the treatment of advanced hepatocellular carcinoma.</p>

Research on forecasting values of the plasma levels for TGF-β, TNF-α and IL-10 in radiation pneumonitis / 中华放射医学与防护杂志

Objective To study the relationship between plasma TGF-β, TNF-α, IL-10 levels and radiation pneumonitis (RP) in patients received thoracic irradiation with 3DCRT. Methods Sixty-nine patients of lung cancer stage Ⅲ or esophageal carcinoma were evaluated prospectively by EUSA for plasma TNF-α, TGF- β, IL-10 levels and IL-10/TNF-α before 3DCRT, after 40 - 50 Gy and after 3DCRT. Results Twenty-eight patients had RP. In RP patients, the plasma TGF-β, TNF-α, IL-10 levels and IL-10/TNF-α was (15.2 ± 13.4) μg/L, (28.4 ± 13.4), (24. 1 ± 17. 1) ng/L and 1.01 ± 0.86 before 3DCRT, respectively;TNF-α increased to (36.1 ± 15.5) ng/L(t = 2.01, P = 0.040), IL-10 and IL-10/TNF-α decreased to (18.8 ± 10.8) ng/L (t =1.40, P = 0.166) and 0.62 0.55 (t = 1.90, P = 0.063)after 40-50 Gy. After 3DCRT TNF-α was higher (36.9 ± 15.5) ng/L than that before 3DCRT(t = - 2.20, P = 0.032) ,but IL-10 and IL-10/TNF-α were lower than that before 3DCRT [(13.7 ± 6.2) ng/L, t = 3.03, P = 0.005 ;0.41 ± 0.21, t = 3.60, P = 0.001]. TGF-β was not change in three times(P > 0.05) .In non-RP patients, TGF-β,TNF-α, IL-10 and IL-10/TNF-α was not yet change in three times(P > 0.05) respectively. TGF-β was not yet change between RP and non-RP patients before 3DCRT (t = 0.54, P = 0.594), and TNF-α was higher in RP group than that in non-RP group after 40-50 Gy(t = 2.02, P = 0.048), but IL-10 and IL-10/TNF-α was less in RP group than that in non-RP group after 3DCRT(t=2.50,P=0.015;t=4.63,P=0.000). Conclusions The levels of TNF-α and IL-10 are closely related to the occurrence of RP. Monitoring the changes in dynamic state could predict the generation of RP, which could be employed as a sensitive index for indicating risks for acute RP.